WO2021138638A1 - Écarteur extensible avec source de lumière facultative et aspiration - Google Patents

Écarteur extensible avec source de lumière facultative et aspiration Download PDF

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Publication number
WO2021138638A1
WO2021138638A1 PCT/US2021/012005 US2021012005W WO2021138638A1 WO 2021138638 A1 WO2021138638 A1 WO 2021138638A1 US 2021012005 W US2021012005 W US 2021012005W WO 2021138638 A1 WO2021138638 A1 WO 2021138638A1
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WO
WIPO (PCT)
Prior art keywords
surgical instrument
fingers
handle
finger
gear
Prior art date
Application number
PCT/US2021/012005
Other languages
English (en)
Inventor
Michelle Rae PANNELL
Original Assignee
Pannell Michelle Rae
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Pannell Michelle Rae filed Critical Pannell Michelle Rae
Publication of WO2021138638A1 publication Critical patent/WO2021138638A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/309—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using white LEDs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system

Definitions

  • the present application relates to medical instruments used in various surgical procedures.
  • illumination of the surgical field is typically achieved through the use of external light sources.
  • Light emanating from an operating microscope is static and may be poorly directed relative to the angle of surgical access.
  • suction devices they are typically connected to a standard suction source to help physicians to dynamically and efficiently remove blood, bone fragments, or fluid previously irrigated into the surgical sites. Often, suction devices are used separately from retractors. Because the surgical space is limited, inserting multiple instruments at the same time increases the operating difficulty and trauma.
  • Retractors with light sources or suction have been developed.
  • Retractors with light sources provide illumination to a surgical field independent of an external light source and enhance visibility to the surgical field.
  • Retractors with suction saves space and enables surgeons to effectively remove blockages from a surgical field.
  • Figure 1 is a perspective view of a retractor according to the preferred embodiment of the present application.
  • Figures 2A and 2B are side views of the retractor of Figure 1 ;
  • Figure 2C is a top view of the retractor of Figure 1 ;
  • Figure 3A is a perspective view of the retractor of Figure 1 showing a set of expandable fingers in a closed position
  • Figure 3B is a perspective view of the retractor of Figure 1 showing a set of expandable fingers in an open position
  • Figures 4A and 4B are perspective views showing a hub controlling the movement of the fingers of the retractor of Figure 1 ;
  • Figure 4C is an enlarged partial perspective view taken from insert 4C in Figure 4B;
  • Figure 5A is a partial assembly view of the retractor of Figure 1;
  • Figure 5B is an enlarged partial perspective view taken from insert 5B in Figure 5A;
  • Figures 6A-6C are a side view, a perspective, and a top view, respectively, of a retractor with stacked fingers according to an alternative embodiment of the present application;
  • Figure 7A is a perspective view of the retractor of Figure 6B showing a set of expandable fingers in a stacked closed position
  • Figure 7B is a perspective view of the retractor of Figure 6B showing the set of expandable fingers in an open position
  • Figures 8A and 8B are perspective views showing a hub controlling the movement of the fingers of the retractor of Figure 6B;
  • Figure 8C is an enlarged partial perspective view taken from insert 8C in Figure
  • Figure 9A is a partial assembly view of the retractor of Figure 6B;
  • Figure 9B is an enlarged partial perspective view taken from insert 9B in Figure
  • Figure 10A is a partial assembly view of the fingers in Figure 8B showing the gear meshing at the finger ends;
  • Figure 10B is an enlarged partial perspective view taken from insert 10B in Figure 10A;
  • Figure 11 is a perspective view of a retractor with a webbing material between fingers according to another alternative embodiment of the present application.
  • Figure 12 is a side view of the retractor of Figure 11 showing an illumination system and a suction system;
  • Figure 13 is a perspective view of the retractor of Figure 11 showing a hub connected to the fingers
  • Figure 14A is a perspective view of the retractor portion of the retractor of Figure 11 showing a set of expandable fingers in a closed position
  • Figure 14B is a perspective view of the retractor portion of the retractor of Figure 11 showing a set of expandable fingers in an open position with a webbing material between fingers.
  • Retractor 1100 includes an expansion handle 1102 on the top, a drive shaft 1106 in the middle, and a base 1108 at the bottom.
  • the shaft 1106 is attached to the handle 1102 and the base 1108.
  • a suction port 1104 and a light port 1105 are attached to the base 1108.
  • the suction port 1104 and the light port 1105 are attached to the base 1108, it should be appreciated that the suction port 1104 and the light port 1105 may be attached to the drive shaft or the fingers internally or externally.
  • the handle shaft can be hollow.
  • a retractor portion 1110 includes a set of expandable fingers 1112, 1113a, 1113b, 1114a, and 1114b that are coupled together at a base 1108.
  • the fingers 1112, 1113a, 1113b, 1114a, and 1114b are generally flat and curved to contour to the shape of the breast or organ. This contour is shown best seen in Figure 2A.
  • the fingers 1112, 1113a, 1113b, 1114a, and 1114b are inserted through an incision of the breast or organ to lift up the tissue while the surgeon performs the surgical procedure.
  • the retractor portion 1110 is operable between a closed position in which fingers 1112, 1113a, 1113b, 1114a, and 1114b are adjacent to each other and an expanded position in which fingers 1112, 1113a, 1113b, 1114a, and 1114b are separated from each other.
  • the fingers 1112, 1113a, 1113b, 1114a, and 1114b are inserted through the incision and then are spread apart by twisting the handle 1102.
  • the handle 1102 includes a means for locking it into place so that fingers 1112, 1113a, 1113b, 1114a, and 1114b do not move unless actuated by the surgeon via handle 1102.
  • retractor 1100 is illustrated in perspective views showing retractor 1100 in a closed, or retracted, position and in an open, or expanded, position, respectively.
  • finger 1112 remains stationary relative to base 1108, while fingers 1113a, 1113b, 1114a, and 1114b rotate relative to base 1108.
  • Fingers 1113a and 1114a rotate in one direct, while fingers 1113b and 1114b rote in an opposite direction. It will be appreciated that the range of rotation of fingers 1113a, 1113b, 1114a, and 1114b may be selectively restricted depending upon the desired operation of retractor 1100.
  • retractor portion 1110 is attached to the drive shaft 1106 via a hub 1201 , which represents a unique retractor gear system.
  • the main bodies of the five fingers 1112, 1113a, 1113b, 1114a, and 1114b are coplanar.
  • the roots of the five fingers 1112, 1113a, 1113b, 1114a, and 1114b are attached to hub 1201 via drive gears.
  • the roots of fingers 1113a and 1113b have upraised portions 1400, which allows clearance for the roots of fingers 1114a and 1114b.
  • hub 1201 is a gear system comprising three gears 1302, 1303, and 1304. Gear 1303 meshes with gear 1302. Gear 1302 and gear 1304 are attached to the drive shaft 1106 and rotate with the drive shaft 1106. Finger 1112 is a central, fixed finger.
  • the gear system 1201 allows fingers 1113a and 1113b to rotate at about one half of the speed of the rotation of expansion handle 1102. Finger 1114a and finger 1114b move at the same speed of the expansion handle 1102.
  • Gear hub 1201 controls the movement and speed of fingers 1113a, 1113b, 1114a, and 1114b.
  • Gear 1302 meshes with gear 1303 and has about one half of the diameter as gear 1303.
  • Gear 1303 has the same gear ratio as the gear portion of finger 1113a and finger 1113b, and gear 1303 meshes with the gear portion of the two fingers.
  • the gear portion at the end of finger 1113a is meshed with the gear portion of finger 1113b rotating in a different direction from the finger 1113a as shown in Figure 5A and Figure 5B.
  • gear 1302 rotates at the same speed as the drive shaft 1106 and causes gear 1303 to rotate at about one half of the speed of the drive shaft. This in turn causes fingers 1113a and 1113b to rotate in opposite directions at about oner half of the speed of the drive shaft 1106.
  • Gear 1304 is engaged with gear 1302 and meshed with the gear portion of finger 1114a and finger 1114b.
  • Gear 1304 has the same diameter as the gear portion of finger 1114a and finger 1114b.
  • gear 1304 rotates at the same speed as the drive shaft 1106 and causes finger 1114a and 1114b to rotate at the same speed of the drive shaft 1106.
  • Retractor 1100 may also include a clevis or other means for gripping the handle shaft 1106. It should be appreciated that the number, shape, and location of fingers and the gear ratio and location can be configured in other ways to meet certain surgical needs. Although the width and general shape of fingers 1112, 1113a, 1113b, 1114a, and 1114b has been shown to be the same, it will be appreciated that the number of, shape, dimensions, and actuation of fingers 1112, 1113a, 1113b, 1114a, and 1114b may vary depending upon the desired operation of retractor 1100.
  • Retractor 2100 includes an expansion handle 2102 on the top, a drive shaft 2106 in the middle, and a base 2108 at the bottom.
  • the shaft 2106 is attached to the handle 2102 and the base 2108.
  • a suction port 2104 and a light port 2105 are attached to the base 2108.
  • the suction port 2104 and the light port 2105 may be attached to the drive shaft or the fingers and can be installed internally or externally.
  • the handle shaft can be hollow.
  • a retractor portion 2110 includes a set of expandable fingers 2112, 2113a, 2113b, 2114a, and 2114b that are coupled together at a base 2108.
  • the fingers 2112, 2113a, 2113b, 2114a, and 2114b are generally flat and curved to contour to the shape of the breast or organ. This contour is shown best seen in Figure 6A.
  • the fingers 2112, 2113a, 2113b, 2114a, and 2114b are inserted through an incision of the breast or organ to lift up the tissue while the surgeon performs the surgical procedure.
  • the retractor portion 2110 is operable between a closed position in which finger 2113a overlaps finger 2114a, and finger 2113b overlaps finger 2114b, and an expanded position in which fingers 2112, 2113a, 2113b, 2114a, and 2114b are separated from each other.
  • the fingers 2112, 2113a, 2113b, 2114a, and 2114b are inserted through the incision and then are spread apart by twisting the handle 2102.
  • the handle 2102 includes a means for locking it into place so that fingers 2112, 2113a, 2113b, 2114a, and 2114b do not move unless actuated by the surgeon via handle 2102. This configuration allows the overall width of fingers 2112, 2113a, 2113b, 2114a, and 2114b to be less.
  • retractor 2100 is illustrated in perspective views showing retractor 2100 in a closed, or retracted, position and in an open, or expanded, position, respectively.
  • finger 2112 remains stationary relative to base 2108, while fingers 2113a, 2113b, 2114a, and 2114b rotate relative to base 2108.
  • Fingers 2113a and 2114a rotate in one direct, while fingers 2113b and 2114b rote in an opposite direction. It will be appreciated that the range of rotation of fingers 2113a, 2113b, 2114a, and 2114b may be selectively restricted depending upon the desired operation of retractor 2100.
  • the fingers 2112, 2113a, 2113b, 2114a, and 2114b are stacked at three different levels. For every finger, the main body of the finger and the root of the finger are coplanar.
  • Finger 2112 is a central, fixed finger attached to the gear cover 2108a as shown in Figure 9A and stacked on the top.
  • Finger 2113a and finger 2113b are under finger 2112 and stacked in the middle.
  • Finger 2114a and finger 2113b are stacked in the bottom.
  • the finger ends of all fingers are attached to hub 2201 by gear meshing.
  • Hub 2201 controls the moving speed of fingers.
  • Hub 2201 is a gear system comprising three gears 2302, 2303, 2304. Gear 2303 meshes with gear 2302.
  • Gear 2303 meshes with gear 2302.
  • Gear 2302 has about one half of the diameter as gear 2303, and gear 2303 has the same gear ratio as the gear portion of finger 2113a and finger 2113b. Gear 2303 meshes with the gear portion of the two fingers 2113a, 2113b. The gear portion at the end of finger 2113a is meshed with the gear portion of finger 2113b rotating in a different direction from the finger 2113a as shown in Figure 8B. As the drive shaft 2106 rotates, gear 2302 rotates at the same speed as the drive shaft 2106 and cause gear
  • Gear 2304 is engaged with gear 2302 and meshed with the gear portion of finger 2114a and finger 2114b.
  • Gear 2304 has the same diameter as the gear portion of finger 2114a and finger 2114b.
  • gear 2304 rotates at the same speed as the drive shaft 2106 and causes fingers 2114a and 2114b to rotate at the same speed of the drive shaft 2106.
  • fingers 2112, 2113a, 2113b, 2114a, and 2114b have been shown to be the same, it will be appreciated that the number of, shape, dimensions, and actuation of fingers 2112, 2113a, 2113b, 2114a, and 2114b may vary depending upon the desired operation of retractor 2100.
  • Retractor 3100 includes a T-shaped handle 3102 at the top, a long neck portion 3106, and a base 3108 at the bottom.
  • the retractor portion 3110 is attached to the neck portion 3106 via a hub 3201 as is best seen shown in Figure 13.
  • Retractor 3100 preferably includes a suction system 3104 and an illumination system 3105.
  • a suction inlet port is on the bottom portion 3203 near the roots of fingers 3112.
  • a suction outlet is on the upper part of the neck portion 3106.
  • the retractor 3110 By connecting the retractor 3110 to a suction pumping system of the type well known to those skilled in the art, blood, bone fragments, or fluid previously irrigated into the surgical sites can be drawn from the surgical area.
  • the suction inlet and outlet are in specified locations in this embodiment, it should be appreciated that the suction inlet and outlet can be situated on fingers 3112 or other parts of retractor 3100.
  • the neck portion 3106 is shown as straight in Figure 11 , it should be appreciated that the neck portion may have a curved configuration that is suitable for angle adjustment.
  • the neck portion 3106 can be made of any material suitable for the purposes described herein, such as silicon, stainless steel, or memory rubber.
  • the retractor 3100 also includes an illumination system 3105.
  • the light emission surface is on the bottom portion 3203 near the finger ends.
  • the light source may be a self-contained battery-operated light, such as one in which the user pulls a tab that allows the battery to come into contact with the lighting circuit; or the light source may be connected via a cable running along the neck portion to terminals located at the top of the neck portion near the handle.
  • the terminals can be configured to connect to a conventional power supply.
  • the light guide directs light to beneath the fingers to illuminate the working area for the surgical procedure.
  • the light guide works in a similar fashion to a fiber optic cable. It is constructed of a transparent material with a polished outer surface. The polished outer surface reflects light back inward, directing it along the length of the guide.
  • Light is supplied into the guide at the connection port by means of a Light Emitting Diode (LED), external light source, or other means.
  • the guide can be either straight or include bends to direct light around corners.
  • the light guide is constructed of non-electrically conductive material which can provide separation between the patient and any electrical components. It should be appreciated that the illumination system 3105 can be situated on fingers or other places and can have other light guiding means.
  • the retractor portion 3110 includes a set of expandable fingers 3112 and a webbing material 3122 between each finger 3112.
  • the fingers 3112 are generally flat and curved to contour to the shape of the breast or organ. This contour is best seen in Figure 12.
  • the fingers 3112 are inserted through an incision of the breast or organ to lift up the tissue while the surgeon performs the surgical procedure.
  • the retractor portion 3110 is operable between a closed position in which fingers 3112 are adjacent to each other, or overlapping each other, and an expanded position in which fingers 3112 are separated from each other.
  • the fingers 3112 are inserted through the incision and then are spread apart by twisting the T-shaped handle 3102.
  • the T-shaped handle 3102 includes a means for locking it into place, so that fingers 3112 do not move unless actuated by the surgeon.
  • the webbing material 3122 between the fingers 3112 prevents the tissue from sagging between the fingers 3112 when the fingers 3112 change from a closed position to an expanded position.
  • Base 3108 includes a hub 3201 and a bottom portion 3203.
  • Hub 3201 can be a rack-and-pinion system, gear system, or other type of linkage that transfers the rotation of the T-shaped handle 3102 to the hub 3201 to cause rotation of fingers 3112.
  • hub 3201 is a lattice system attached to the retractor portion 3110, whereby one end finger 3112 is fixed to the hub 3201 and the opposing end finger 3112 is moved by twisting the T-shaped handle 3102. As the opposing finger 3112 moves away from the fixed finger 3112, the other fingers 3112 make corresponding movements.
  • this coordinated movement of fingers 3112 may be accomplished by small pivoting pieces between every finger that are moved by the hub 3201.
  • the retractor portion 3110 is shown in a closed state in Figure 14A and in an expanded state in Figure 14B. Retraction may be achieved by placing the retraction portion 3110 in a closed state into an incision. With the help of the illumination system 3105, surgeons can clearly see the configuration of the tissues and twist the T-shaped handle 3102 to move a certain number of fingers 3112 to intended locations. The webbing material 3122 between the fingers 3112 prevents the tissue from sagging between the fingers 3112 when the fingers 3112 change from a closed position to an expanded position. This retractor is flexible in creating space relative to the structures of the tissues.
  • surgeons want to widen or narrow the incision they only need to adjust the distances between fingers and do not need to replace the retractors. This saves surgical time and reduces invasion harm.
  • the suction system 3104 can be used to remove the blockages.
  • the fingers 3112 can be move to a less expanded state. Finally, the retractor portion 3110 in a less expanded state is removed from the incision.
  • Each of the retractors disclosed herein preferably includes a locking mechanism, such as a knob, a detent, a locking tab, or a locking clamp, which allows the fingers to be secured in a selected position.
  • each of the retractors disclosed herein may include one or more switches, knobs, and/or controls for controlling the operation of the lighting systems, the suction systems, and/or the retraction systems.
  • Retractor 3100 has several advantages. One is that the retractor is easy to operate. The surgeon only needs to use one hand to operate the handle and keep several parts of the skin or tissue retracted. The surgeon is free to use the other hand to perform other surgical procedures. Another benefit is minimizing invasion.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Surgical Instruments (AREA)

Abstract

Un instrument chirurgical comprend une partie d'écarteur ayant une pluralité de doigts qui sont mobiles entre un état déployé et un état fermé. L'instrument chirurgical peut comprendre un système d'éclairage et/ou un système d'aspiration.
PCT/US2021/012005 2020-01-03 2021-01-01 Écarteur extensible avec source de lumière facultative et aspiration WO2021138638A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202062957114P 2020-01-03 2020-01-03
US62/957,114 2020-01-03

Publications (1)

Publication Number Publication Date
WO2021138638A1 true WO2021138638A1 (fr) 2021-07-08

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PCT/US2021/012005 WO2021138638A1 (fr) 2020-01-03 2021-01-01 Écarteur extensible avec source de lumière facultative et aspiration

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Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5549636A (en) * 1994-10-05 1996-08-27 Li Medical Technologies Inc. Surgical grasper with articulated fingers
US5554101A (en) * 1991-08-05 1996-09-10 United States Surgical Corporation Surgical retractor
US5722935A (en) * 1995-05-05 1998-03-03 Minnesota Scientific, Inc. Laparoscopic retractor having a plurality of blades extending laterally from a handle
US20080108877A1 (en) * 2006-05-22 2008-05-08 Ardeshir Bayat Disposable expandable cordless lighted retractor
US7445598B2 (en) * 2002-05-09 2008-11-04 Tyco Healthcare Group Lp Endoscopic organ retractor and method of using the same
US20130190575A1 (en) * 2011-08-31 2013-07-25 Lanx, Inc. Lateral Retractor System and Methods of Use
WO2019075328A1 (fr) * 2017-10-13 2019-04-18 Generations International Asset Management Company Llc D/B/A International Private Bank Écarteur chirurgical éclairé

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5554101A (en) * 1991-08-05 1996-09-10 United States Surgical Corporation Surgical retractor
US5549636A (en) * 1994-10-05 1996-08-27 Li Medical Technologies Inc. Surgical grasper with articulated fingers
US5722935A (en) * 1995-05-05 1998-03-03 Minnesota Scientific, Inc. Laparoscopic retractor having a plurality of blades extending laterally from a handle
US7445598B2 (en) * 2002-05-09 2008-11-04 Tyco Healthcare Group Lp Endoscopic organ retractor and method of using the same
US20080108877A1 (en) * 2006-05-22 2008-05-08 Ardeshir Bayat Disposable expandable cordless lighted retractor
US20130190575A1 (en) * 2011-08-31 2013-07-25 Lanx, Inc. Lateral Retractor System and Methods of Use
WO2019075328A1 (fr) * 2017-10-13 2019-04-18 Generations International Asset Management Company Llc D/B/A International Private Bank Écarteur chirurgical éclairé

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